title: Effects of postoperative epidural analgesia on recurrence-free and overall survival in patients with nonsmall cell lung cancer.
abstract: OBJECTIVE
  To determine whether postoperative epidural analgesia is associated with better recurrence-free survival and overall survival after lung cancer surgery.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  Academic hospital.
  
  
  METHODS
  Data of patients with stage 1, stage 2, and stage 3 nonsmall cell lung cancer, who underwent tumor resection surgery, were studied. Patient data were grouped into three different postoperative pain management interventions: intravenous patient-controlled analgesia, patient-controlled epidural analgesia, and their combination. Univariate and multicovariate Cox proportional hazards models were applied to assess the effects of covariates of interest on overall survival and recurrence-free survival.
  
  
  RESULTS
  The type of postoperative analgesia used for patients who underwent surgery for nonsmall cell lung cancer did not affect recurrence-free survival or overall survival. However, certain variables, including age ≥ 65 years, male gender, body mass index ≥ 25 kg/m(2), ASA physical status 4, and the need for preoperative blood transfusions, pneumonectomy, and postoperative radiation, were associated with decreased recurrence-free survival and overall survival.
  
  
  CONCLUSIONS
  The type of postoperative analgesia used after surgery for nonsmall cell lung cancer is not associated with better 2-year or 5-year recurrence-free survival or overall survival rates.
authors.affiliation: Department of Anesthesiology and Perioperative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA. Electronic address: jcata@mdanderson.org.
authors.forename: Juan P
authors.initials: JP
authors.lastname: Cata
authors.affiliation: Department of Anesthesiology and Perioperative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
authors.forename: Vijaya
authors.initials: V
authors.lastname: Gottumukkala
authors.affiliation: Department of Anesthesiology and Perioperative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
authors.forename: Dilip
authors.initials: D
authors.lastname: Thakar
authors.affiliation: Department of Anesthesiology and Perioperative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
authors.forename: Dinesh
authors.initials: D
authors.lastname: Keerty
authors.affiliation: Department of Pain Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
authors.forename: Rodolfo
authors.initials: R
authors.lastname: Gebhardt
authors.affiliation: Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
authors.forename: Diane D
authors.initials: DD
authors.lastname: Liu
mesh_terms: D000367:Age Factors; D000368:Aged; D000577:Amides / Q000494:pharmacology; D015360:Analgesia, Epidural / Q000379:methods*; D016058:Analgesia, Patient-Controlled / Q000379:methods; D000701:Analgesics, Opioid / Q000494:pharmacology; D000779:Anesthetics, Local / Q000494:pharmacology; D015992:Body Mass Index; D002045:Bupivacaine / Q000494:pharmacology; D002289:Carcinoma, Non-Small-Cell Lung / Q000601:surgery*; D004359:Drug Therapy, Combination / Q000379:methods; D005260:Female; D005283:Fentanyl / Q000494:pharmacology; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D004091:Hydromorphone / Q000494:pharmacology; D008168:Lung / Q000601:surgery; D008175:Lung Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control*; D059408:Pain Management / Q000379:methods; D010149:Postoperative Pain / Q000188:drug therapy*; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D000077212:Ropivacaine; D012737:Sex Factors; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D000577:Amides; D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D000077212:Ropivacaine; D004091:Hydromorphone; D005283:Fentanyl; D002045:Bupivacaine
keywords: Analgesia; Epidural; Intravenous; Nonsmall cell lung carcinoma; Patient-controlled; Postoperative